带血管甲状腺-甲状旁腺移植术5例报告

用带血管的胎儿甲状旁腺移植术治疗甲状旁腺机能低下症,共行手术6次(腹腔内移植5次,股三角区移植1次),6次中有3例术后发生4次排斥反应。经1年8月至3.5年随防,疗效显著者2例,有效2例,失败1例。本文讨论了有关甲状旁腺移植的手术方法、注意事项、免疫抑制剂应用等问题。     

Brain tissue reaction following intracerebral injection of free or liposomally encapsulated BSH

Boron neutron capture therapy (BNCT) is a potentially valuable treatment of malignant brain gliomas. A primary requirement for successful BNCT is achieving high local concentration of boron drugs in tumors. Intratumoral injection of liposomes containing boron drug has potential to meet this requirement and could prove to be of significance for BNCT. The brain tissue reaction following the intracerebral injection of a boron drug, BSH, either in solution form or in liposomally encapsulated form, was studied in rats. On histological examination, no evidence of tissue reaction was found after injecting BSH solution, suggesting that high local concentration of BSH was well tolerated. Injection of liposomal BSH was characterized by phagocytic activity at the site of injection, which was regressing by 24 h. Neither group of animals exhibited any signs of abnormal behavior or neurologic deficit. Direct intracerebral injection of BSH liposomes as per-formed in this report could be regarded as tolerable.     

ACTIVIT OF HUMAN PLACENTAL GAMMA GLOBULININ BLOCKING IMMUNE FUNCTIONS IN VITRO AND IN ABROGATING THE XENOGENEIC, LOCAL GRAFT-VERSUS-HOST-REEACTEON

In order to understand the mechanism of immunosuppression caused by infusion of placental gamma globulin (PGG) in patients with renal allografts, rheumatoid arthritis, and graft – versus –host disease (GCHD) following bone marrow transplantation (BMT) ,we have examined the effect of PGG in vitro and in a model of the xenogeneic , local graft –ver- sus – host reaction (LGVHR) .PGG inhibited lymphocyte proliferation in mixed lymphocyte cultures (MLC) (P<0.005) and depressed interleukin -2 (IL-2) levels in such cultures at 72 hours (P<0.01) . In contrast phytohemagglutinin (PHA) –and pokeweed mitogen (PWM) –induced T and B lymphocyte blastogenesis was not affected by such PGG treatment .PGG treatment .PGG neither decreased the [3H] TdR pulse incorporation in unstimulated lymphocytes nor affected cell viability .Cell cycle analysis by flow cytometry showed that PGG reduced the percentage of cells in S and G2, M phases during the MLC, but did not alter cell cycling during PWM-stimulated proliferation . An immunosuppressive effect of PGG on the LGCHR was tested in a model of intracutaneous transplantation of PGG –treat human lymphocytes into cyclophosphamide – immunosuppressed rats. Lymphoprep – separated human tonsillar lymphocytes were incubated with RPMI-1640 buffer containing：（1）PGG,4mg/ml,(2) human plasma albumin,4mg/ml,(3)mitomycin-C,25ug/ml, or (4) no additive. Cell of each preparation (3x107cells in 0.1ml) were injected intracutaneously into cyclophosphamide-treated male rats at separate abdominal locations. A fifth site received only the buffer solution. Five days after injection of cells ,each rat received [125 I]IUdR (10uCi) intraperitoneally and was killed after 5 hours. For each site of injection, the diameters of induration were measured and 125 I was counted . There was no difference between buffer – treated and a ibumin – treated groups either in the diameter of the area of induration (t=0.66;P>0.5)or in radioactive counts(t=0.22;P>0.05).In the PGG –treated group, the induration and radioactivity measurements were significantly less than in control groups (t=3.72 and P<0.1;t=2.62 and P<0.02,respectively ) Cytophilic antibodies in PGG were thought to inhibit an early phase of T cell activation, and not to be cytotoxicity .In the LGVHR, the immune response might be abrogated either by immuno- regulatory suppression of T cell function or by toxicity to the infused lymphoid cells. For some clinical purposes, immuno- modulating, human antibodies might be preferred to murine, monoclonal antibodies.     

100例2型糖尿病患者交感神经皮肤反应研究

目的探讨交感神经皮肤反应(SSR)检测在评价2型糖尿病(T2DM)自主神经损害中的价值.方法对100例T2DM患者进行SSR检测,30例健康志愿者作为对照.结果2组SSR的起始潜伏期、N波潜伏期、波幅、面积比较差异有显著性意义(P＜0.05),P波潜伏期差异无显著性意义(P＞0.05).T2DM组72例(72%)患者至少有一肢SSR异常.血糖控制满意组和血糖控制不良组比较,起始和N波潜伏期差异有统计学意义(P＜0.05),波幅和面积无显著性意义(P＞0.05).T2DM组病程＜5年与病程≥5年比较,潜伏期、波幅、面积差异均无统计学意义(P＞0.05).结论SSR可作为评价T2DM自主神经损害的客观电生理指标;T2DM患者SSR与血糖控制水平相关,与病程无关.     

Preparation and evaluation of lectin-conjugated PLGA nanoparticles for oral delivery of thymopentin.

The purpose of this study was to design and evaluate lectin-conjugated PLGA nanoparticles for oral delivery of thymopentin. Thymopentin loaded PLGA nanoparticles (TP5-NPs) were prepared by a double emulsion-solvent evaporation technique. Novel WGA-PLGA conjugates were synthesized by coupling the amino groups of wheat germ agglutinin (WGA) to the carbodiimide-activated carboxylic groups of PLGA, and were incorporated into nanoparticles preparation to take mucoadhesive properties. Important characteristics such as particle size, zeta potential, entrapment efficiency, storage stability, as well as in vitro drug release behavior were investigated. The retention of biorecognitive activity of WGA after covalent coupling was confirmed by haemagglutination test. In vitro experiments with pig mucin (PM) demonstrated that the conjugation of WGA enhanced the interaction about 1.8-4.2 fold compared with that of the non-conjugated nanoparticles, and still exhibited sugar specificity. The pharmacodynamical studies on oral administration of WGA-TP5-NPs were performed in FACScan flow cytometry. The values of CD4(+)/CD8(+) ratios were significantly increased compared with that of TP5-NPs (p<0.01). The enhanced uptake was related to the increasing of WGA content on nanoparticles. These results confirmed that the conjugation of WGA onto PLGA nanoparticles effectively improved the intestinal absorption of TP5 due to specific bioadhesion on GI cell membrane.     

神经导航内窥镜辅助下单鼻孔入路垂体腺瘤切除

目的神经导航、内窥镜辅助下垂体腺瘤的经单鼻孔经蝶手术治疗。方法对6例经磁共振成像诊断垂体腺瘤的病人术前进行磁共振成像定位,将影像资料输入导航工作站,作术前手术计划。采用零度及45度镜经单鼻腔,在导航的动态指引下确认鞍底,于内窥镜下实施瘤实质切除。结果本组5例完全切除,1例因为瘤实质较韧而作大部分切除,术后病人的视力均得到了改善。导航预期误差1.48mm,实际误差1.8mm。结论神经导航引导下的经鼻蝶垂体腺瘤手术定位准确,内窥镜下操作对鼻腔的解剖结构影响小、组织损伤轻,病人恢复快。     

复发性脑胶质瘤及其放射治疗

1976～1986年肿瘤科收治脑胶质瘤42例,10例复发,其中6例采用单纯放疗,用~60钴γ线。5例脑胶质瘤予肿瘤区局部照射,DT44～57Gy/6-7周,1例髓母细胞瘤予全脑、肿瘤区及全脊髓照射、脑中平面量DT38Gy/5周;肿瘤区51Gy/7周;脊髓18Gy/8周。结果:有效1例,显效2例,无效3例。本研究提示对于已不能釆用其他手段治疗的复发病人,放疗仍有一定效果。     

Distribution of rat facial motoneurons and its reorganization following nerve reinnervation]

OBJECTIVE: To examine the distribution of rat facial motoneurons contributing different branches under normal situation and when nerve reinnervation occurred following facial nerve axotomy. METHODS: The normal distribution of motoneurons innervated both buccal and marginal mandibular branches and its reorganization after facial nerve reinnervation was observed using retrograde labeling with fluorescein. RESULTS: Under normal situation, the motoneurons contributing buccall and marginal mandibular branches were primarily distributed in the intermedial and lateral subnucleus in facial nucleus and almost completely overlapped. The two types labeled neurons organized closely, but there were no double-labeled neurons. Although the motoneurons contributing buccall and marginal mandibular branches were primarily overlapped 4 month post-anastomosis, the number of the labeled neurons obviously decreased and the organization got more scattered. There were 10% of buccall branches, 5% of marginal mandibular motoneurons in the dorsal subnuleus, 1% of buccall and 4% of marginal mandibular in dorsal ventral and medial subnucleus. The distribution pattern of the motoneurons 6 month post-anastomosis was similar to that of 4 month post-anastomosis, but the number of the labeled neurons increased, and there were 1%-2% double-labeled neurons. CONCLUSION: The distribution pattern of motoneurons innervated both buccal and marginal mandibular branches indicates that it should exist wide-spread communicating branches, and its reorganization after facial nerve reinnervation suggests that misdirected regeneration occurs among motoneurons innervating different branches.     

静脉输液加药后的微粒变化

本文对我院急诊病人常用的供静脉给药的22种药物、42组配伍情况,制成静脉加药输液,在超净工作台条件下,用KF—4型微粒计数器,测定了168次微粒数,结果显示输液加药后微粒虽有增加,但均在药典规定范围内。输液中加1种、2种、3种药物后所产生的微粒数分别为x_1=5.52(n_1=16);x_2=8.17(n_2=18)、x_3=10.25(n_3=8),经统计处理,三组间无显著差异(P<0.05)。本文对产生微粒的药物、注射器、操作环境等因素进行了分析。